SUMMARY We propose holding the fourth iteration of the International Conference on Applications of Neuroimaging to Alcoholism (ICANA-4). Each of the prior three ICANA Conferences, held in New Haven, CT in 2004, 2008, and 2013, drew over 100 leading investigators from around the globe to focus on techniques, conceptual issues, and findings related to application of a dynamically evolving set of neuroimaging tools and approaches to the study of alcohol use and alcohol dependence. Our ICANA conferences have drawn broad attention, including publications in the Journal of the American Medical Association (JAMA) and Alcoholism: Clinical and Experimental Research. The proposed conference would be another seminal event that would draw leading imaging experts together to advance our knowledge about the neurological effects, development, and treatment of alcoholism and alcohol use. Established investigators who work in other areas of brain imaging, as well as those already working in alcoholism-related areas, will be convened to share methodological applications to alcoholism and foster collaboration across modalities. Special efforts will be made to support the attendance and participation of research trainees, fellows, and new investigators. The proposed program would utilize the format of the earlier conferences and include an international roster of speakers in a two-and-one-half day conference. The audience is expected to include 100-150 researchers from around the world. The interest level in this fourth meeting is already quite high, as indicated by our speaker commitments and by the agreement of Dr. George Koob, Director of NIAAA, to give the opening plenary presentation of the conference. The proposed meetings dates are July 19-21, 2019. The proposed agenda includes 5 main topics. Each topic will include discussion of the diversity of imaging techniques used to study the specific topical area: (1) Reward Learning and Habit; (2) Stress and Craving of Alcoholism; (3) Inflammation and Alcohol; (4) Structural and Functional Connectivity in Alcohol Use Disorder; and (5) Pharmacoimaging. The conference will include plenary presentations, sessions discussing the variety of imaging techniques (fMRI, MRS, PET/SPECT) used to study alcohol use, neuroimaging in preclinical and clinical studies, and the applications of neuroimaging to the development of treatments for alcohol dependence.